Polycystic Ovary Syndrome Key Factor in Depression

Up to one-third of all women with polycystic ovary syndrome will develop symptoms of depression, largely irrespective of their age, according to recent findings from a group of Polish researchers.

Polycystic ovary syndrome (PCOS) is the accepted term for a grouping of symptoms that indicate a potentially serious disruption of a woman’s reproductive and non-reproductive health. Depression is one of the known symptoms of the condition. In a study published in January 2015 in the European Journal of Obstetrics & Gynecology and Reproductive Biology, researchers from Poland’s Medical University of Warsaw used a small-scale project to estimate how often women with PCOS experience depression. The researchers used data from the same project to help determine if age is a significant factor in the association between depression and polycystic ovary syndrome.

Polycystic Ovary Syndrome

Polycystic ovary syndrome gets its name from its characteristic feature: the formation of lingering cysts inside the ovaries, where egg production and the opening stages of ovulation take place. Underlying this problem is lack of the hormone mixture needed to promote proper egg maturation. In addition to cyst formation inside the ovaries, symptoms of the syndrome include infertility caused by incomplete ovulation, altered menstruation, pain in the pelvic region, skin darkening and thickening in several body areas (including the breasts and arms), abdominal obesity (excessive weight gain centered on the abdomen), sleep apnea (abnormal pauses in breathing during sleep), acne, the development of a pattern of baldness usually found in men and unusual hair growth in body areas such as the chest, abdomen, toes or face.

One of the primary contributing factors to the onset of PCOS is overproduction of sex hormones called androgens, which normally appear in much higher amounts in men than in women. In turn, overproduction of these hormones in women may be linked to the overproduction of the blood sugar-controlling hormone called insulin. Roughly 5 percent to 10 percent of all American women able to bear children have polycystic ovary syndrome, the federal Office on Women’s Health reports. The high-end estimate equates to approximately 5 million individuals. Females age 11 and older can develop PCOS.

Depression and Women

The American Psychiatric Association recognizes the existence of a range of depression-based illnesses, including major depression (the most severe and well-known of the illnesses), persistent depressive disorder (also called dysthymia) and mood dysregulation disorder. Depressive conditions specific to women include premenstrual dysphoric disorder and a major depression offshoot called postpartum depression. American women develop diagnosable forms of depression as much as 70 percent more often than American men. However, at least some of this gender disparity may be explained by doctors’ known tendency to over-identify depression symptoms in women and/or under-identify depression symptoms in men.

Depression and PCOS

In the study published in the European Journal of Obstetrics & Gynecology and Reproductive Biology, the Medical University of Warsaw researchers used a project involving 60 women to help estimate the rate of depression in women with polycystic ovary disease. All of the study participants had diagnosable symptoms of PCOS. Each participant submitted basic information and testing data that included her age, blood levels of androgen hormones, cholesterol levels and body fat level as measured by a standard test called the body mass index or BMI. In addition, each woman took three screening tests designed to detect and measure depression symptoms, including the Beck Depression Inventory and the Quick Inventory of Depressive Symptomatology—Self-Report. Roughly half of the participants were age 26 or younger.

After analyzing the data, the researchers concluded that polycystic ovary syndrome is clearly linked to heightened risks for depression. The level of risk found among the study participants varied according to the screening test in use. At the low end, 22 percent of the PCOS-affected women had diagnosable indications of depression. At the high end, fully one-third (33 percent) of the women had such depression indications. The researchers found that women in the study group over the age of 26 had negligibly higher chances of developing depression symptoms than their younger counterparts.

The researchers also identified some of the factors associated with the occurrence of depression in women with polycystic ovary syndrome. Among women 27 and older, these factors include having a relatively high BMI score, abdominal weight gain and having any combination of high “bad” cholesterol (i.e., LDL cholesterol), low “good” cholesterol (i.e., HDL cholesterol) or high total cholesterol. Among women 26 and younger, the associated factors were abdominal weight gain and a high BMI score.17

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